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The storm's punishing winds and muddy brown floodwaters destroyed or severely damaged thousands of homes, crippled hospitals and trapped people in attics.

"It's total devastation. It's decimated. Apocalyptic," said Lia Head-Rigby, who helps run a local hurricane relief organisation and flew over the Bahamas' hard-hit Abaco Islands.

"It's not rebuilding something that was there; we have to start again."

In this handout aerial photo provided by the HeadKnowles Foundation, damage is seen from Hurricane Dorian on Abaco Island on September 3, 2019 in the Bahamas (Image: Getty Images)

She said her representative on Abaco told her that there were "a lot more dead" and that the bodies were being gathered.

The prime minister also expected more deaths and predicted that rebuilding would require "a massive, coordinated effort".

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With their heads bowed against heavy wind and rain, rescuers began evacuating people from the storm's aftermath across Grand Bahama late on Tuesday, using jet skis, boats and even a huge bulldozer that cradled children and adults in its digger as it cut through deep waters and carried them to safety.

In this USCG handout image,damage is seen to a marina as Coast Guard Air Station Clearwater forward-deployed four MH-60 Jayhawk helicopter crews in support of search and rescue and humanitarian aid in the Bahamas, September 2, 2019 (Image: Getty Images)

One rescuer gently scooped up an elderly man in his arms and walked toward a pickup truck waiting to evacuate him and others to higher ground.

Practically parking over a portion of the Bahamas for a day and a half, Dorian pounded the northern Abaco Islands and Grand Bahama with winds of up to 185mph and torrential rain before finally moving into open waters on Tuesday on a course for Florida.

Its winds were down to a still-dangerous 110mph late on Tuesday, making it a Category 2 storm.

More than two million people along the coast in Florida, Georgia and North and South Carolina were warned to evacuate.

While the threat of a direct hit on Florida had all but evaporated, Dorian was expected to pass dangerously close to Georgia and South Carolina - and perhaps strike North Carolina - on Thursday or Friday.

Even if landfall does not occur, the system is likely to cause storm surge and severe flooding, the US National Hurricane Centre said.

"Don't tough it out. Get out," said US Federal Emergency Management Agency official Carlos Castillo.

In the Bahamas, Red Cross spokesman Matthew Cochrane said more than 13,000 houses, or about 45% of the homes on Grand Bahama and Abaco, were believed to be severely damaged or destroyed.

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UN officials said more than 60,000 people on the hard-hit islands will need food, and the Red Cross said some 62,000 will need clean drinking water.

"What we are hearing lends credence to the fact that this has been a catastrophic storm and a catastrophic impact," Mr Cochrane said.

The Red Cross authorised 500,000 US dollars (£413,000) for the first wave of disaster relief, Mr Cochrane said.

And UN humanitarian teams stood ready to go into the stricken areas to help assess damage and the country's needs, spokesman Stephane Dujarric said. The US government also sent a disaster response team.

Abaco and Grand Bahama islands, with a combined population of about 70,000, are known for their marinas, golf courses and all-inclusive resorts. To the south, the Bahamas' most populous island, New Providence, which includes the capital city of Nassau and has more than a quarter of a million people, had little damage.

Julia Aylen wades through waist deep water carrying her pet dogs as she is rescued from her flooded home during Hurricane Dorian in Freeport, Baham (Image: AP)

The US Coast Guard airlifted at least 21 people injured on Abaco.

"We will confirm what the real situation is on the ground," Health Minister Duane Sands said. "We are hoping and praying that the loss of life is limited."

Mr Sands said Dorian rendered the main hospital on Grand Bahama unusable, while the hospital in the town of Marsh Harbour in Abaco was in need of food, water, medicine and surgical supplies.

He said crews were trying to airlift five to seven kidney failure patients from Abaco who had not received dialysis since Friday.

Late on Tuesday, Dorian was centred about 95 miles east of Cape Canaveral, Florida, and it was moving northwest at 6mph.

Hurricane-force winds extended up to 60 miles from its centre, while tropical storm-force winds could be felt up to 175 miles from the core.

The coastline from north of West Palm Beach, Florida, through Georgia was expected to get three to six inches of rain, with nine inches in places, while the Carolinas could get five to 10 inches and 15 in spots, the National Hurricane Centre said.